I've met a fair number of travelers who remain at the same hospital for years. Really it is up to the facility. However, as soon as you work over one year in the same area (even at five different hospitals), or sign a contract that takes you over one year, that becomes your new tax home on that day. Since a good bit of your take home pay derives from the tax benefits of working away from home, it may not benefit you financially to travel to only one location. Becoming perm with staff benefits could be better with good health insurance (usually), PTO, vacation, holiday pay, and education.

There are a good number of agencies that are willing to pay those tax benefits forever, some with a mandatory trip home, others with a 30 day time out, and while those do protect the agency from the IRS, they do not protect the traveler. Those tax liabilities just pile up for as much as seven years and if you are audited, you will owe back taxes, penalties, and interest - perhaps as much as six figures in just a few years. It is not worth the risk in my opinion no matter the low audit risk (although the audit risk increases if the agency gets audited because of their own poor due diligence about tax homes).

You may already be in this position if you are not maintaining a residence you can return to at anytime at your tax home. This cannot be artificial, you have to have real ties to your tax home - ideally working there every year but it is not required if you have other real ties like your church, voter registration, spouse, historical place of residence, et cetera. If you don't have this, you are itinerant (without a tax home) and so everywhere you work is home, and you are subject to taxes on all your compensation, just like everyone else who lives there and is not working away from home on business. Nothing wrong with being itinerant, and it could be better financially in some cases. If it cost more than about $10,000 a year to maintain a residence, than being itinerant is the way to go.

If your tax home shifts to an assignment location you have been at for over a year or most of your income comes from there over a couple years even if you do an assignment somewhere else, then you will owe that work state taxes on all your income, just as you would owe your permanent tax home somewhere else as a traveler their share of all income earned anywhere. Itinerants only owe income tax to the work state, potentially saving money over someone with a tax home in a state with high income tax.

Oct 30, '17

Great information on the tax angle in the above post.

Another aspect is individual hospital policy. Some hospitals will limit the number of contracts because they don't want "permanent travelers." Travelers are generally more expensive for the hospital than hiring permanent staff and the hospital doesn't want people moving into the area to think they can just work as a traveler there forever. And they don't want their existing staff to start working for the travel company -- which would cost them more money. So they set a limit as to how many contracts they will allow 1 person to have.

Oct 30, '17

Yup, I agree. I mentioned it was up to the hospital. It is certainly understandable in some markets that they do not want to pollute the local labor pool but it is not always about the money. Hospitals have better control over employees to ensure they fit into the culture and follow policies and get appropriate ongoing education. It can also benefit morale and reduce turnover with enlightened management. But is other markets, you just cannot get staff for several possible reasons including lack of local schools and bad management. In those places, a traveler can work contracts for as long as they like. I've met travelers who have been over two years in the same place.

The agency doesn't really care other than some who will make the traveler take a "time out" to protect the agency from the IRS.

Nov 10, '17

I'm extending my first 13 week contract and feel like I've found my new home. Maybe it's still the honeymoon phase but I wouldn't mind settling down here! It was anxiety inducing waiting for my renewal to be approved by the hospital/negotiated by my company but it's a relief to know that I'm staying in a place that's so comfortable.

Mar 21

Thanks for this information!!!

Apr 13

I've stayed at one hospital for 9 months but this is unusual. 3 months is typical. I've met a nurse who's had the same travel assignment for 2.5 years. This is probably a record.